Extended Data Fig. 4: Microvascular haemolysis is widespread in organs from individuals with an ischaemic event, COVID-19, septic and cardiogenic shock patients.
From: Ischaemic endothelial necroptosis induces haemolysis and COVID-19 angiopathy
a, Representative confocal images depicting obstructive lysed RBCs (CD235+H) in ischaemic human heart and brain tissues, with magnified images depicting lysed RBCs on the vessel wall (arrows) and between intact RBCs (arrowheads). Scale bars, 20, 50, 10 µm from top to bottom. The associated graphs present the % of vessels containing lysed RBCs (control & ischaemic heart: n = 4 & 3, control & ischaemic brain: n = 2 & 1, respectively). b, Representative confocal IF/DIC images of widefield and CLEM images of single villus capillaries depicting obstructive lysed RBCs (CD235+H or TER-119+H) in the gut tissues of COVID-19 patients (left panels), ischaemic patients (middle panels) and IR-injured mice (right panels). Magnified CLEM images (lower panels) depicting lysed RBCs (CD235+H or TER-119+H) with distinct morphologies (SEM) in the villus capillaries. Scale bars, 20 and 50 µm for top and middle, respectively (Gut tissue from 4 COVID-19 patients, 5 ischaemic patients, 3 human controls and sham-operated mice, 8 IR-treated mice). c, Representative confocal/DIC images showing microvascular RBC haemolysis (CD235+H, arrowheads) in the indicated organs from patients with cardiogenic, post-traumatic or septic shock; Scale bar, 20 µm (c-i). Graphs depicting the percentage of EC death and intravascular RBC haemolysis in septic and cardiogenic shock patients (Sepsis: n = 4 patients; Shock: n = 3) (c-ii,iii) and correlation between percentage of vessels obstructed by lysed RBCs and EC death in tissues from patients with sepsis, cardiogenic shock and non-COVID-19 ARDS (n = 12 organs from 8 patients) (c-iv). Note - Sepsis biopsies: colon, skin and abdominal wall; Sepsis autopsy: kidney; Cardiogenic or traumatic shock tissue biopsies: 2 hearts and 1 liver; ARDS autopsies: 3 kidneys and 3 livers. Data represents the mean ± SD, Statistical analysis: two-sided t-test (a) or one-sided Pearson’s r (c-iv).
